The Safety And Efficacy Of Laparoscopic Versus Open Surgery In Lateral Lymph Node Dissection For Mid-low Rectal Cancer: A Meta-analysis

Objective:To evaluate the safety and efficacy of laparoscopic versus open surgery in lateral lymph node dissection(LLND)for mid-low rectal cancer.Methods:We searched the related database by computer and collected the clinical research papers related to this study from January 2000 to October 2019.The quality of the literature was evaluated and then Revman 5.3 software was used for meta-analysis.Results:A total of 593 patients were included in 7 literatures,including 243 patients in the laparoscopic surgery group and 350 patients in the open surgery group.Compared with the open group,the laparoscopic group had a longer operative time(WMD=98.55,95%CI=29.43 ~ 167.68,P=0.005),but less intraoperative blood loss(WMD=-467.16,95%CI=-665.42~-278.89,P<0.00001),shorter postoperative hospital stay(WMD=-7.12,95%CI=-11.14~-3.09,P=0.0005).R0 resection rate,lateral lymph node harvest,lateral lymph node metastasis,local recurrence,3-year overall survival,and 3-year disease-free survival did not differ significantly between the two approaches(P≥0.05).Conclusion:Laparoscopic LLND has no obvious disadvantage in radical tumor treatment and longterm survival,but it has the advantages of less intraoperative bleeding and shorter hospital stay.Laparoscopic LLND is a safe and feasible surgical approach.